AUGUSTA, Maine — A provision of Maine’s controversial health reform law would be expanded under new legislation to include the state’s smallest businesses, in an effort to lower their insurance costs.
The reform law, passed last spring in the wake of heated partisan debate, overhauled the health insurance market for about 40,000 people who buy coverage through the individual market or through employers with fewer than 50 workers, known as the small group market. It also created a separate pool to cover the sickest residents in the individual market.
Now, a new bill seeks to include businesses, specifically those with fewer than six employees, in the high-risk pool. A public hearing on the bill, sponsored by Sen. Jon Courtney of Springvale, the Senate Republican majority leader, is scheduled for Wednesday before the Legislature’s Insurance and Financial Services Committee.
“Some of the very small groups weren’t getting the full benefits as soon as we would like,” Courtney said.
Under the law, microbusinesses will be hit by greater premium fluctuations than their larger counterparts, according to an independent consultant’s report presented to lawmakers last month. Including them in the pool, known as the Maine Guaranteed Access Reinsurance Association, could alleviate that variability, Courtney said.
The high-risk pool is funded primarily by a fee charged to nearly all private policyholders in the state. Insurers also pay a fee for each member they relinquish to the pool.
Expanding the pool to include microbusinesses would presumably cost more, though the bill doesn’t address additional funding.
“We need to help those microbusinesses afford their health insurance,” said Rep. Sharon Treat of Hallowell, the ranking Democrat on the Insurance and Financial Services Committee. “Whether this approach is sustainable financially is an open question.”
Treat pointed to the consultant’s report, which predicted a $12 million deficit if the state includes microbusinesses in the reinsurance pool.
The report, prepared by Gorman Actuarial of Massachusetts, includes a number of assumptions because lawmakers haven’t fully ironed out the health reform law’s implementation.
Maine’s law also allows insurers to set rates based on a business’ size. The federal Affordable Care Act does away with group size rating in 2014, however, putting serious time pressure on the proposal to expand the risk pool, said David Clough, Maine director of the National Federation of Independent Business.
“The idea, on one hand, sounds good,” he said. “On the other hand, it seems difficult to achieve.”
If I understand it correctly, the plan is to artificially shift regular-risk small business into the high risk category to exploit a loophole in the law that redistributes high risk premiums among regular risk policies. The manoeuvre is designed to counteract premium penalties that insurance companies are artificially assigning to regular-risk small companies. Is that it?
This is an example of two wrongs making a right, and I can say that I’m not unhappy and I’m not happy. 2014 won’t arrive soon enough.
That’s a tough one. It certainly would be nice for the smaller businesses to offer benefits to employees, at a reasonable cost to both. But, we haven’t ironed out the Maine Affordable Care Act passed last year, why? I don’t know. It may have something to do with attention being placed on other “things”, by a certain somebody.
I think that perhaps the best way to do something like this would keep with the spirit of the legislation, but not go full in. How about a pilot program for select small businesses that express a desire to give it a shot? It it fails, it’s at a reduced cost than going full in; and if it succeeds, well great. But they have got to stop sending things out to “study”, it costs money that can never be recovered, and frequently does not provide useful additional information.
Typical obstructionism.
“… but not go full in. How about a pilot program for select small businesses that express a desire to give it a shot? It it fails, it’s at a reduced cost than going full in; ”
Half hearted, with plans for failure.
It is just like the Republics feel about the economic recovery .
No compromise.
I hear ya……but I think that prudence should trump a commitment? And you?
I also believe that change become much more permanent and concrete if you do it slowly, rather than abruptly. It’s like a circle, once you find the middle, you can calculate your directions; up, down, sideways or backwards, but you will always know where the middle is.
I was motivated by the folly of being reasonable, anymore.
While I’m glad you understood where I’m coming from, and took it the right way,
how sad is that, too ?
lol
But yeah, there is something to said for sneaking up on those that oppose all change
in a world where change is the only constant.
Just more discrimination for those who are apt to actually USE the Insurance!
These insurance companies should be required to charge One Rate for ALL!
In a way, that’s what we’ve been living with. Because Maine has been a “guaranteed issue” state, the insurance companies are not allowed to price policies based on past health problems, smoking, weight, etc. They have to price Maine as a “one size fits all” customer base. That’s part of what’s driven up the costs! My family runs a small business with 3 employees and we just had to drop our health insurance because we couldn’t afford the $1300+/month bill and that was only to cover 2 of us and our children. It’s crazy.
one trip to the ER an its a $1300 plus other medical cost like a mri ect.
We will achieve savings in health care when we eliminate the insurance company leeches that skim 31 cents of every dollar off the top and no sooner.
Universal single payer is the only viable solution.
And pray tell what have Mr LePage and his republican brethern ( far right side) cast upon us in the name of health care? So far they have insured ( small pun ) that the counties with those least able to pay will get the highest rates and an attempted to gut MaineCare affecting large numbers of the elderly, handicapped, disabled and children. Now they want to place the smallest of small business in a high risk pool with little or no guarantee of success.
And that my friends is what I would call a “death Nell” for small business.
FEE: PC R term for TAX.
I think it should be illegal for an insurance company to raise rates by 50% in one year! Also the State of Maine’s Law: Over 75% of your employees must be covered by health insurance! That law means that if a couple of your employees decide that they don’t want insurance then the companies entire health insurance policy is dropped for every employee! This law is just ridiculous!
At the rate that these insurance companies slice and dice the risks in a few years they will be having rate premiums for “Individuals”!
Yes you are right an the older you get the more you pay an you have on going medical problems you pay more
As a single cell business owner hoping to be a micro someday, i have to much to do let alone worry about employees health care insurance though i would care about their health.This issue of health care should be the individuals.Isn’t workers comp enough for a business to deal with?Imagine how much easier it would be if everyone was insured.Health care is a right not a privilege to be controlled by wall street. As a matter of national security i would support a nationalization of the health care system and only the health care system.
Obama’s proposed streamlining of the SBA with other administrations should take the time burden of small business compliance into account and offer online programs and one day fix-all seminars for businesses to one stop shop. Single payer would alleviate the burden on small and large business (except insurance companies), by putting everyone in the same boat.
Another bill w/o a way to fund it…
Single Payer Medicaid For All.
yessah
There is no quick fix for this issue. Personal responsibility is key in this. We have to start as individuals and look to the horizon for change.
And, I didn’t see health care a a right in the bill of rights, but maybe my copy is different than the previous person’s copy.
The problem is you can be responsible all you want, once accident and trip to the ER can Cost 1300 dollars or more. If you get cancer, there goes everything.
No you did not see it in the bill of rights, Look up general welfare clause.